Les troubles du sommeil sont présents pendant la grossesse et pendant le post-partum. L’objectif de notre travail est de comprendre la physiopathologie de ces troubles et leurs rôles dans la psychopathologie de la femme enceinte et de prévoir le risque de survenue de troubles psychiatriques.

Nous avons réalisé une revue de la littérature sur les troubles du sommeil en période périnatale. Nous avons retenu les articles qui font le lien entre le sommeil et la psychopathologie pendant cette période.

La grossesse affecte le sommeil sur le plan qualitatif et quantitatif. Les perturbations du sommeil sont évolutives et sujettes aux variations physiologiques propres à la grossesse, si bien qu’elles deviennent plus accentuées. Les répercussions sur l’humeur sont variables, elles peuvent aller de l’irritabilité à l’épisode dépressif caractérisé. Le retour à un sommeil réparateur après l’accouchement est difficile, favorisant les décompensations psychiatriques précoces du post-partum. Les facteurs étiologiques de ces perturbations sont multiples, ce qui limite l’efficacité de la réponse thérapeutique en plus des difficultés à la prescription médicamenteuse.

Les troubles du sommeil sont sous-estimés chez la femme enceinte ; ils doivent être recherchés et traités lorsqu’ils sont invalidants afin de prévenir la survenue des troubles de l’humeur et leurs conséquences sur le lien mère enfant.

Sleep disorders commonly occur in pregnancy and during post-partum. The aim of our study is to investigate the physiopathology of these disturbances and their putative role in the psychopathology of pregnant and puerperal women, in particular analysing their relationship with mood disorders.

Trough a revision of relevant literature, we reported the most significant evidence regarding the relationship between sleep disorders and psychopathology in pregnancy and post-partum.

Pregnancy modifies sleeping both qualitatively and quantitatively. Sleep disorders are evolutionary, frequently reported during perinatal period and associated with the hormones variations of pregnancy. Pregnant women complained of a low sleep quality. Endocrine origin was the most frequent cause in the first quarter of pregnancy. While during the third quarter, the sleep disturbance was associated to physical concerns related to the body's modification (such as : abdominal growth, gastric burns, muscle cramps, urgency urinary and polyuria. The dreams, nightmares are more frequents in pregnancy period, the mechanisms of the increase of dreams is unclear, the hormonal and physical modifications during pregnancy as well as the psychological processes of becoming a mother seem to play a role. The unpleasant dreams and nightmares increase the distress and damage the quality of sleep Impact of sleeping disorder on the mood of pregnant women varies from irritability to depression. Their relation with characterized depressive episode remains difficult to estimate. Let us note the association between a poor sleep and an arisen of a likely depression. (The bad quality of the sleep precedes the appearance of a depressive signs). The prenatal stress participates in the insomnias. Moreover, lack of sleep, in the last days of pregnancy is associated with a longer work, one felt painful increased, and a difficult delivery. A spontaneous release of the premature work was also noticed. Finally it can favour the rise of one intense baby blues this a risk factor of evolution towards a maternal depression. Sleeping repair during post-partum is difficult because of the rough hormonal modifications, baby blues, the feeding and the rhythm of the baby. The quantitative lack sleep is accompanied with tiredness, diurnal slumber, and difficulties to concentrate, what increases the painful real-life experience of its disturbances. Unfortunately the exploration of sleeping disorders is difficult and the realization of randomized studies turns out to be challenging. The coverage of sleeping disorders during the pregnancy remains complex and difficult. The etiological factors of these disturbances are multiple, which limits the efficiency of the therapeutic answer besides the difficulties to the medicinal prescription. A premature intervention allows to warn the psychiatric complications at the mother and to protect the interactions mother-baby.

Sleeping disorders are underestimated in the follow-up of pregnant women, they must be looked for and taken care of when they are invalidating to warn the arisen of the disorders of the mood and their consequences on the link between mother-child.